Ending a therapy session
I’m getting more and more practice in being in the therapy role, having now qualified to the point where in practice sessions I can say ‘I’m a trainee therapist’ (until this course, I had to call myself a ‘helper’).
So much of both the courses I’ve done are about reflection. Not only reflecting on yourself, but reflecting on what therapy and being a therapist means.
This will almost definitely turn into a vague series of posts on being a therapist and boundaries.
I want to talk about boundaries and patterns of relating as a therapist, and as someone who’s also in therapy.
In the very first therapy session, some therapists will go through a ‘contract’. We do in person-centred, at least.
In contracting we cover practicalities of timing of sessions, cancellation processes, where to escalate complaints to. We’ll cover the ethical body we’re registered with, what type of therapy we do and how it works. Depending on the practice we might also get emergency/next of kin contact details. If we’re in person we might cover fire safety and where the bathrooms are. It’s a setting of expectations really.
Most importantly we cover confidentiality, what it means, and when we might need to break it (with or without the client’s consent)
These are all boundaries. It lays out, right at the start, the terms and space within which therapy will take place. The client then has the option to consent or not to these terms.
I want to talk about a specific boundary and dive into what it can mean, on a deeper level, to enforce and manage this boundary.
Let’s talk about ending a session
In my training we take a few minutes at the end of the session to wrap up and ground the client. This is to make sure the session doesn’t end abruptly, but also to start to transition the client out of ‘therapy mode’ and back into their day to day.
We’ve been taught to summarise what we’ve spoken about in the session, checking with the client that we’ve got a good understanding of what they’ve been talking about during the session.
This reinforces to the client that we have been listening, and to help the client reflect on what we’ve covered, because sometimes it can be a surprising amount in a short space of time.
Then we ground them back in the present. Normally this is asking a question such as what the client is doing for the rest of the day. It brings the client back to the immediate, and starts moving them out of ‘therapy mode’.
(As someone in therapy, I find this incredibly useful. Firstly, having someone summarise the session can show just how much I’ve covered in one session. It’s also a way to see what stood out and what we explored more. A highlight reel of sorts. Then talking about the rest of my day acts as a reset of sorts. It can still absolutely be the case that you’re still reeling post-therapy, but this still brings you back into the now).
You might be thinking that this is such a gentle boundary that it barely counts. It is really a given that appointments will start and end on time, but there’s a lot here.
Doing what we say we’ll do and managing a possibly emotionally difficult session well is a big thing. It means we’re holding space for people in a set way, and people know what to expect. Its a way of managing expectations in a space where the client is the one setting the direction of the session. It allows the client to not have to think about the timing of sessions or if they’re running over, which frees them up to focus on what they’ve brought to the session.
It’s also a boundary that absolutely gets pushed. Someone might have a breakthrough towards the end of a session, and we still have to manage that session to end on time, even if the client wants to continue talking about it. Even if we want the client to keep talking about it. We have to keep that boundary.
Therapy is all about patterns
Patterns of relating, patterns of thought, patterns of behaviour. Having this boundary set and managed is a pattern of relating. It’s a healthy boundary that as therapists we manage.
Therapy might be one of the first places where someone sees healthy boundaries being set (see last week’s post for boundaries vs rules/boundaries as punishments).
I know in my own therapy I discussed how I felt about being in therapy, including not knowing much about my therapist, and how it felt weird to not ask the therapist how they were doing/how their week had been etc.
We explored where these feelings came from and how this looked in other relationships, and in what way therapy was a departure from other patterns of relating for me.
Showing interest in a client's day to day is also a way to show that we see and value the person as a whole. While we spend most of our time looking at whatever the client is bringing to sessions, having a minute to talk about an interest, a commute, whatever the rest of the day holds is a way to see a whole person. It reminds the client that they are also a whole person, and more than whatever is going on for them emotionally.
The smallest boundary can be absolutely deep and meaningful, especially in a therapy session. I’ve not even spoken about time keeping as a form of respect/self-respect, or integrity and how this folds into the ethical framework that a therapist works within.
I find pulling out things like this fascinating, it’s amazing how small boundaries can absolutely lead to bigger breakthroughs.
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